超声诊断胆管癌的误诊分析及改进方法探讨

Study of mis-diagnosis of cholangiocarcinoma by ultrasonography and work in progress

目的探讨造成肝外胆管癌超声诊断的误诊的具体因素。方法对超声误诊的32例肝外胆管癌的误诊因素进行回顾性分析,并与其它影像学检查对照。结果共有4例假阳性和28例假阴性病例,以下段及上段胆管癌误诊率较高。团块型及狭窄型易误诊为肝内胆管结石、胰头或壶腹部癌、胆管炎症;2例误诊为肝癌;部分因肥胖和胃肠道气体干扰而误诊。结论胆管癌的超声误诊的具体因素较多,通过结合病史、临床症状,禁食饮水排除气体干扰,多切面观察,结合其它影像学检查可降低胆管癌的误诊率。

Objective To study the factors leading to the mis-diagnosis of cholangiocarcinoma by ultrasonography. Methods The data of 32 cases of cholangiocarcinoma which is mis-diagnosed by uhrasonography were reviewed and compared with other imaging results. Results Totally 28 false negnative cases of cholangiocarcinoma were misdiagnosed as hepatolithiasis, pancreatocarcinoma, carcinoma of ampulla and cholangeitics. There were 4 cases false pasitive. Among those , gastric gas interference and stenosis were the major factors leading to misdiagnosis. Conclusion Varied factors leads to mis-diagnosis of cholangiocarcinoma by uhrasonography .Clinical symptoms history and other imaging examinations should be combined to improve the diagnostic rate.